Botox or Laser on Deep, Vertical Forehead Creases?

Doctor Answers 7

Botox, Juvederm and Fractional CO2

April 2nd, 2011

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Deep wrinkles on the forehead do require multiple treatment modalities. I would first start off with Botox, maximizing the amount on the forehead. Botox , or even Dysport, will relax the muscles and smooth out the lines, however they will not completely eliminate them. After 2 weeks, I will re-evaluate again. I love the fractional CO2 laser and I typically do it 2 weeks after Botox injection. The CO2 will help but do not completely remove the lines either. 6 weeks after the fractional CO2, I re-evaluate again. Sometimes, I repeat the fractional CO2 (touch-up) or at this point consider adding Juvederm to the area. Out of all the treatment mentioned above, the CO2 is the one with the longest lasting results. Its important to emphasize that if you want to get a fractional co2 for the creases, I would strongly advice Botox 2 weeks prior to the procedure. Your final results will be much improved. Dr Behnam, Santa Monica.

I've been using Botox for over 20 years and have done many Laser Skin resurfacing. Botox is easy, safe and highly effective at reducing forehead lines and wrinkles without the recovery and healing time that a deep Laser skin resurfacing may have. Why not try the Botox first and see if you're happy.

Botox, filler and laser might be the answer

May 26th, 2009

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It’s hard to imagine your condition without seeing a photo. Normally, if the forehead creases are related to motion of the underlying muscle, then laser won’t help much as the lines come back as you continue to move the muscle despite the smoother skin surface from laser. Botox would help in this situation but , the areas of insertion needed to improve your lines might involve areas we normally don’t inject so as to avoid producing an unwanted droop. A filler might be a better treatment. See a physician who is experienced in laser, Botox and fillers. Many dermatologists and plastic surgeons would be very capable to evaluate your condition.

Botox Pictures

Perhaps "all of the above"

April 27th, 2009

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I'd love to see a picture, but when someone has very deep and etched lines, Botox, then fractional CO2 2 weeks later, then filler like Restylane or Juvederm about 3 months later can be the trifecta of non-surgical shaping , smoothing and rejuvenating. Of course, I'd need to see your skin type and get a good history to make a recommendation for your unique needs.

Vertical forehead creases between the eyebrows

April 27th, 2009

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I would suggest Botox either at the same time or preferably followed 2 weeks later by hyaluronic acid filler (Restylane or Juvederm). The Botox is for the "dynamic" component of the wrinkles (with movement) and the filler is for the "static" component (wrinkles at rest).

Perhaps both, or...

Botox would likely be the better choice (especially if the creases are between the eyebrows). You may also be a great candidate for a brow lift, which will take care of the problem long term.

The vertical wrinkles are due to muscle pull (dynamic wrinkles), while laser is better at treating static wrinkles (wrinkles not associated with muscle pull). You may ultimately benefit from all of the modalities, but would recommend Botox and possibly brow lift.

Botox, Laser, and Fillers Can Be required in the case of vertical creases

April 27th, 2009

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These vertical creases can be somewhat more complex and difficult to treat than transverse or horizontal creases. Many times we will start with Botox and then determine whether Juvederm or Restylane injections might be required as well. Use of a Carbon Dioxide Laser may be helpful but only if the more non-invasive steps do not satisfy the patient.

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